Glaviano Neal R, Zuk Emma F, Sheldon Lauren, DiStefano Michael, Devaney Laurie
Sport Optimization and Rehabilitation Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
Institute for Sports Medicine, University of Connecticut, Storrs, CT, USA.
J Sport Rehabil. 2025 Jan 20:1-7. doi: 10.1123/jsr.2024-0108.
Handheld dynamometers provide clinicians an objective measure of lower-extremity force production at the hip and knee. While push-based dynamometers are common in clinical practice, they can be associated with patient discomfort, and standardization of methods is challenging when patient forces can exceed the ability of the rater. Development of novel, pull-based dynamometers allow for better patient comfort, but validity between dynamometers must be established before integration into clinical practice. Therefore, the purpose of this study was to compare measurement of lower-extremity force between push- and pull-based handheld dynamometers.
Descriptive laboratory study.
Twenty-one healthy triathletes performed isometric hip abduction, hip external rotation, and knee extension testing against 2 separate handheld dynamometers. Pearson product correlations were calculated for the relationship between devices, while Bland-Altman plots were used to measure agreement with limit of agreement to assess systematic bias.
Correlations between devices were strong for hip abduction and knee extension (r = .743-.767, P < .001) and moderate for hip external rotation (r = .429, P = .052). Additionally, there was good agreement between the 2 devices, with acceptable limits of agreement across the 3 force tasks. The pull-based dynamometer resulted in greater torque values for knee-extension and hip external rotation, with a mean difference of -0.37 and -0.19 N·m/kg, but there was no difference in hip abduction with a mean difference of 0.03 N·m/kg.
The results demonstrate that pull-based dynamometers are an acceptable alternative to push-based dynamometers for hip abduction and knee extension, but some caution may exist for hip external rotation. Clinicians should be aware of differences in lower-extremity force across multiple handheld dynamometers when assessing muscle function in practice.
手持测力计为临床医生提供了一种客观测量髋部和膝部下肢体力量产生的方法。虽然基于推的测力计在临床实践中很常见，但它们可能会给患者带来不适，并且当患者的力量超过评估者的能力时，方法的标准化具有挑战性。新型基于拉的测力计的开发使患者感觉更舒适，但在将其整合到临床实践之前，必须确定不同测力计之间的有效性。因此，本研究的目的是比较基于推和基于拉的手持测力计对下肢力量的测量。
描述性实验室研究。
21名健康的铁人三项运动员使用2种不同的手持测力计进行等长髋关节外展、髋关节外旋和膝关节伸展测试。计算了两种设备之间关系的Pearson积差相关系数，同时使用Bland-Altman图测量一致性并确定一致性界限以评估系统偏差。
两种设备之间，髋关节外展和膝关节伸展的相关性很强（r = 0.743 - 0.767，P < 0.001），髋关节外旋的相关性中等（r = 0.429，P = 0.052）。此外，两种设备之间具有良好的一致性，在3项力量测试中的一致性界限均可接受。基于拉的测力计在膝关节伸展和髋关节外旋时产生的扭矩值更大，平均差异分别为 -0.37和 -0.19 N·m/kg，但髋关节外展时没有差异，平均差异为0.03 N·m/kg。
结果表明，对于髋关节外展和膝关节伸展，基于拉的测力计是基于推的测力计的可接受替代方案，但对于髋关节外旋可能需要谨慎。临床医生在实践中评估肌肉功能时应注意不同手持测力计测量的下肢力量差异。
